Three years back I joined a club no one wants to be a member of. I became a parent who lost their beautiful child to suicide. He was 20. I didn’t think it was possible. I trusted his doctors to take good care of him. I trusted they would tell me if there was a real risk of him dying, given I am his mother and was his prime carer. I thought they had the expertise to identify and address ‘crisis’ when they saw it. Suicide was not in the script. It was not supposed to happen. I turn the fact of his sudden traumatic death over and over in my head and it makes no sense.
There are hundreds of distraught and bewildered members of this club. Common themes emerge from their stories. The commonest one is:
“They knew our child wanted to end his/her life but they didn’t tell us anything about it.”
Who are they?
Decision makers – Medics. Universities.
Because he/she is over 18, hence, technically an adult.
Their ‘confidentiality’ is paramount.
Is it more important than helping them stay alive?
The Hippocratic oath states:
“I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.”
According to experts, these are the essential components of an effective suicide prevention safety plan:
- Discussing the reasons for living
- Safe environment
- Identify distress triggers
- Removing ways to harm yourself
- Activities to calm/lift mood or distract
- Contacts for general support
- Specific suicide prevention support
- Professional support
- Emergency contact details
- Personal commitment to follow safety plan
Most of the above cannot be implemented without the help of carers and families if the person in question is seriously unwell. This has been recognised by the Department of Health, Royal Colleges of Psychiatrists, GPs and Nursing along with The British Association of Social Workers and The British Psychological Society. Together they published a consensus statement entitled “Information Sharing and Suicide Prevention” in 2014, the same year that my son, Saagar Naresh passed away. It clearly states that practitioners should disclose information to an appropriate person or authority if this is necessary to protect a child or young person from risk of death or serious harm.
“If the purpose of the disclosure is to prevent a person who lacks capacity from serious harm, there is an expectation that practitioners will disclose relevant confidential information, if it is considered to be in the person’s best interest to do so.”
This is still not being practised. The world of medicine is a conservative and defensive one. Until the regulatory bodies, NHS Trusts and the Government come forward to reassure practitioners that their decision to share information appropriately will be supported by them, nothing will change.
While the world carries on, innocent youngsters die from lack of support and understanding from the very people who are best placed to help them. PAPYRUS, a UK charity dedicated to prevention of young suicides demands that information be appropriately shared with carers and families by all who take care of vulnerable young people at risk of suicide.
Confidentiality versus Life. It’s a no-brainer.